2024-05-10T12:57:15-05:00 2023-06-30 410746749 CLIFTONLARSONALLEN LLP 220 S 6TH STREET SUITE 300 MINNEAPOLIS MN 55402 990 2022-07-01 370909113 APARTMENT COMMUNITY OF OUR LADY OF THE SNOWS APAR 7633472200 6499 UNIVERSITY AVE NE 300 MINNEAPOLIS MN 55432 KEVIN RYMANOWSKI CFO 7633472200 2024-05-09 1 KEVIN RYMANOWSKI 999009999 1 MACKENZIE MCNAUGHTON P02025805 6123764500 2024-05-09 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z BENEDICTINE LIVING COMMUNITY - AT THE SHRINE JERRY CARLEY 6499 UNIVERSITY AVE NE 300 MINNEAPOLIS MN 55432 9450844 0 0928 X WWW.BENEDICTINELIVING.ORG X 1966 IL ADVANCING THE LIFE-ENHANCING SENIOR CARE MINISTRY OF THE BENEDICTINE SISTERS OF DULUTH, MINNESOTA 10 6 210 12 0 0 648803 375 7703016 9239099 1429196 205133 8612 6237 9789627 9450844 32682 46050 0 0 4695079 5069689 0 0 0 3705893 4209583 8433654 9325322 1355973 125522 28630744 29245514 9423272 8951338 19207472 20294176 X WE ARE A CATHOLIC, FAITH-BASED ORGANIZATION ENTRUSTED WITH ADVANCING THE LIFE-ENHANCING SENIOR CARE MINISTRY OF THE BENEDICTINE SISTERS OF DULUTH, MINNESOTA. WE WITNESS TO GOD'S LOVE BY CREATING INCLUSIVE COMMUNITIES, SUPPORTING THOSE WE SERVE TO LIVE WELL AND WITH PURPOSE, WITH SPECIAL CONCERN FOR THE UNDERSERVED. 0 0 7859465 46050 9239099 BENEDICTINE LIVING COMMUNITY AT THE SHRINE PROVIDES HEALTH CARE AND OTHER RELATED SERVICES TO THE ELDERLY. FACILTIES INCLUDE A 57-BED SKILLED NURSING FACILITY WHICH WHICH HAD AN AVERAGE CENSUS OF 42.3 RESIDENTS, 30 SHELTER CARE UNITS THAT HAD AN AVERAGE CENSUS OF 29 RESIDENTS, AND 89 INDEPENDENT LIVING APARTMENTS THAT HAD AN AVERAGE OCCUPANCY OF 84.5. THE COMMUNITY SERVED 283 INDIVIDUALS DURING THE FISCAL YEAR ENDED 6/30/23. 7859465 1 0 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 37 0 1 210 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 6 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X KEVIN RYMANOWSKI 7636896107 6499 UNIVERSITY AVE NE SUITE 300 MINNEAPOLIS MN 55432 JERRY CARLEY CEO OF BHS 1.00 40.00 X X 0 654097 158313 KEVIN RYMANOWSKI CFO & TREASURER 1.00 40.00 X X 0 389056 83733 ANNELIESE PETERSON SVP OF BENEDICTINE 1.00 40.00 X X 0 15046 0 JENNIFER BRUHN OPERATIONS VP 1.00 40.00 X X 0 212586 45164 RONALD STEPHENS CHAIR 1.00 0.00 X X 0 0 0 AMY BALANCE DIRECTOR 1.00 0.00 X 0 0 0 CHERYL BRUNSMANN DIRECTOR 1.00 0.00 X 0 0 0 REV JAMES CHAMBERS OMI DIRECTOR 1.00 0.00 X 0 0 0 MICHAEL MCMANUS DIRECTOR 1.00 0.00 X 0 0 0 ROY LANTRY DIRECTOR 1.00 0.00 X 0 0 0 HEATHER STITCH EXECUTIVE DIRECTOR 40.00 0.00 X 0 123615 11981 CHARITY ANN SCHAFFNER RN 40.00 0.00 X 117977 0 121 STEVE PZRYBILLA FORMER SVP OF BENEDICTINE 1.00 40.00 X 0 414389 9338 117977 1808789 308650 1 1 1 0 PATHWAY HEALTH SERVICES 11240 STILLWATER BLVD N SUITE 1000 LAKE ELMO MN 55042 INTERIM STAFFING SERVICES 110833 1 375 375 RESIDENT SERVICES 623000 9239079 9239079 SUPPORT FEES 900099 20 20 9239099 205133 205133 MISCELLANEOUS REVENUE 900099 6237 6237 6237 9450844 9239099 0 211370 46050 46050 4188912 3714496 474416 36099 36099 535401 535401 309277 309277 564343 564343 500 500 10298 10298 834941 756826 78115 43782 43782 69829 16021 53808 770269 685668 84601 44749 29096 15653 236527 236527 665651 665651 112596 112596 FOOD 462018 462018 MEDICAL SUPPLIES 249224 226322 22902 LICENSE SURCHARGE 112520 112520 EQUIPMENT LEASES 11660 11660 20676 15833 4843 9325322 7859465 1465857 0 1026431 403006 64233 130547 6341 556 12235171 1616690 10599206 10618481 8249603 8531498 16255 8828 8668675 9552598 28630744 29245514 691002 840535 168664 132693 1398000 935500 6756221 6521403 409385 521207 9423272 8951338 X 19207472 20286046 8130 19207472 20294176 28630744 29245514 X 125522 951866 9316 X 0 1 X 1 0 X 97910 69394 21931 648803 375 838413 8428254 8153773 10820348 7703016 9239099 44344490 8526164 8223167 10842279 8351819 9239474 45182903 0 50969 50969 50969 50969 45131934 272465 345101 525656 1429196 205133 2777551 272465 345101 525656 1429196 205133 2777551 124725 92683 35151 8612 6237 267408 8923354 8660951 11403086 9789627 9450844 48227862 0.93580 0.94160 0.05760 0.05820 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 124,725. 2019 AMOUNT: $ 92,683. 2020 AMOUNT: $ 35,151. 2021 AMOUNT: $ 8,612. 2022 AMOUNT: $ 6,237. PART III, SHORT YEAR EXPLANATION: THE YEAR ENDED 6/30/21 WAS A SHORT YEAR RETURN SPANNING 1/1/21 TO 6/30/21. THIS LINE WAS COMBINED WITH 1/1/21-12/31/21 TO CREATE THE 2021 COLUMN. 0 1 X 37810 37810 10669089 1231115 9437974 482190 59930 422260 838445 325645 512800 207637 207637 10618481 RESTRICTED CASH 4344015 RESTRICTED DEPOSITS 1132304 FUNDS HELD BY TRUSTEE 4068149 INVESTMENT IN FOUNDATION 8130 9552598 AMOUNTS DUE TO AFFILIATES 155826 ASSET RETIRMENT OBLIGATION 365381 521207 X PART IV, LINE 2B: SECURITY DEPOSITS PART X, LINE 2: THE ORGANIZATION HAS BEEN DETERMINED TO QUALIFY AS A TAX-EXEMPT CHARITABLE, EDUCATIONAL, AND SCIENTIFIC ORGANIZATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND ALSO HAS BEEN DETERMINED TO BE EXEMPT FROM STATE INCOME TAX. THE ORGANIZATION FOLLOWS THE ACCOUNTING STANDARD FOR CONTINGENCIES IN EVALUATING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. THE STANDARD PRESCRIBES RECOGNITION AND MEASUREMENT OF TAX PROVISIONS TAKEN OR EXPECTED TO BE TAKEN ON A TAX RETURN THAT ARE NOT CERTAIN TO BE REALIZED. THE ORGANIZATION'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION FILES ALL APPLICABLE RETURNS FOR ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. 1 BENEDICTINE HEALTH SYSTEM 6499 UNIVERSITY AVE NE SUITE 300 MINNEAPOLIS MN 55432 411531892 501(C)(3) 46050 0 SYSTEM SUPPORT & FOUNDATION SUPPORT 1 0 PART I, LINE 2: TRANSFERS BETWEEN RELATED ORGANIZATIONS ARE ACCOUNTED FOR IN INTERNAL FINANCIAL STATEMENTS, OF WHICH ALL ARE UNDER COMMON CONTROL. 0 0 0 0 0 0 0 0 0 JERRY CARLEY CEO OF BHS 0 531906 0 13264 0 108927 0 134579 0 23734 0 812410 0 0 KEVIN RYMANOWSKI CFO & TREASURER 0 344257 0 6421 0 38378 0 65610 0 18123 0 472789 0 0 STEVE PZRYBILLA FORMER SVP OF BENEDICTINE 0 311697 0 0 0 102692 0 8435 0 903 0 423727 0 0 JENNIFER BRUHN OPERATIONS VP 0 183732 0 1500 0 27354 0 36054 0 9110 0 257750 0 0 PART I, LINE 3 BENEDICTINE HEALTH SYSTEM'S (EIN: 41-1531892) CEO, JERRY CARLEY, SHARE HIS TIME BETWEEN THE REPORTING ORGANIZATION AND RELATED ORGANIZATIONS. THE CEO IS COMPENSATED BY BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION. THIS ORGANIZATION USES THE FOLLOWING TO SET CEO/ADMINISTRATIVE COMPENSATIONS: 1. COMPENSATION COMMITTEE 2. INDEPENDENT COMPENSATION CONSULTANT 3. WRITTEN EMPLOYMENT CONTRACT 4. COMPENSATION SURVEY OR STUDY 5. APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE FORM 990, PART VI, SECTION A, LINE 1A THE EXECUTIVE COMMITTEE (COMPRISED OF THE CHAIR, VICE-CHAIR, BOARD SECRETARY, AND THE CHAIRS OF THE STANDING COMMITTEES) IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD IN THE INTERVAL BETWEEN MEETINGS OF THE BOARD, PROVIDED, HOWEVER, THAT IT MAY NOT DETERMINE MATTERS OF POLICY WITHOUT PRIOR SPECIFIC AUTHORIZATION OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 THE CORPORATION CONTRACTS WITH BENEDICTINE HEALTH SYSTEM, A RELATED ORGANIZATION, FOR MANAGEMENT SERVICES. BENEDICTINE HEALTH SYSTEM EMPLOYED THE ADMINISTRATOR/CEO OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 6 BENEDICTINE HEALTH SYSTEM, A MINNESOTA NONPROFIT CORPORATION, IS THE SOLE MEMBER OF THE CORPORATION. FORM 990, PART VI, SECTION A, LINE 7A EACH DIRECTOR OF THE CORPORATION IS APPOINTED BY BENEDICTINE HEALTH SYSTEM. FORM 990, PART VI, SECTION A, LINE 7B BENEDICTINE HEALTH SYSTEM HAS CERTAIN RESERVED POWERS RELATING TO THE ACTIVITIES OF THE CORPORATION AS SET OUT IN THE CORPORATION'S BY-LAWS. IN ADDITION, IN KEEPING WITH THE CORPORATION'S MISSION "TO ASSIST AND COORDINATE ACTIVITIES OF FACILITIES FOR HEALTH CARE, EDUCATION, AND CARE FOR THE AGED AND SOCIAL SERVICES IN ACCORDANCE WITH THE CHARITABLE WORKS TRADITION OF THE ROMAN CATHOLIC CHURCH", ALL ACTIVITIES OF THE CORPORATION ARE REQUIRED TO BE CARRIED OUT IN ACCORDANCE WITH THE CHARISMS OF THE BENEDICTINE SISTERS BENEVOLENT ASSOCIATION ("BSBA"), A CIVIL LAW CORPORATION FOR THE SISTERS OF ST. BENEDICT OF ST. SCHOLASTICA MONASTERY LOCATED IN DULUTH, MINNESOTA. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON INFORMATION PROVIDED BY MANAGEMENT. THE RETURN WAS THEN REVIEWED BY THE CFO. AN ELECTRONIC COPY OF THE FORM 990 WAS DISTRIBUTED TO THE GOVERNING BODY PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS SIGN A CONFLICT OF INTEREST POLICY ANNUALLY. THIS POLICY STATES THE PROCEDURES FOR DISCLOSING A POTENTIAL CONFLICT OF INTEREST. AN INTERESTED PERSON MUST DISCLOSE HIS/HER INTEREST TO THE BOARD. THE BOARD THEN DETERMINES IF AN INTEREST EXISTS. IF AN INTEREST EXISTS, THE BOARD THEN INVESTIGATES ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. IF A PERSON OF INTEREST IS SUSPECTED OF FAILING TO DISCLOSE A POSSIBLE CONFLICT OF INTEREST, THEY WILL THEN BE GIVEN AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. THE BOARD WILL THEN DETERMINE IF THE MEMBER HAS IN FACT FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST. IF THE MEMBER KNOWINGLY FIALED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, THE BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS. THIS COMMITTEE IS COMPRISED ENTIRELY OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE REVIEWS DATA ON COMPENSATION PROVIDED TO INDIVIDUALS HOLDING COMPARABLE POSITIONS IN COMPARABLE ORGANIZATIONS IN ORDER TO ESTABLISH A REASONABLE COMPENSATION RANGE. THE DATA IS COLLECTED AND REVIEWED WITH THE COMPENSATION COMMITTEE BY AN INDEPENDENT CONSULTANT. BASED ON THE MARKET DATA AND IN LIGHT OF ANY SPECIFIC INDIVIDUAL BENEDICTINE HEALTH SYSTEM 41-1531892 QUALIFICATIONS, THE COMPENSATION COMMITTEE DETERMINES COMPENSATION. THE DELIBERATIONS AND DETERMINATIONS OF THE COMPENSATION COMMITTEE ARE RECORDED CONTEMPORANEOUSLY AND PROVIDED TO THE GOVERNING BODY FOR REVIEW. COMPENSATION FOR THE CFO, OTHER OFFICERS, AND OTHER KEY EMPLOYEES OF THE ORGANIZATION IS DETERMINED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICTS OF INTERST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. FORM 990, PART XI, LINE 9: CHANGE IN INTEREST IN FOUNDATION 8,130. NET RECEIPTS FROM FOUNDATION 1,186. BENEDICTINE FOUNDATION 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411513014 FUND DEVELOPMENT MN 501(C)(3) LINE 10 BHS 1 BENEDICTINE HEALTH CENTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411381401 SENIOR LIVING COMMUNITY MN 501(C)(3) LINE 10 BHS 1 ARROWHEAD SENIOR LIVING COMMUNITIES 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411978619 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 STEEPLE POINTE SENIOR LIVING COMMUNITY 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411852273 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 STGERTRUDE'S HEALTH CENTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411848720 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 SAINT ANNE OF WINONA 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 410850791 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 ROSEWOOD COURT 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 412011389 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 REGINA SENIOR LIVING 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 463700475 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 MADONNA TOWERS OF ROCHESTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411809914 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 MADONNA MEADOWS OF ROCHESTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 470855891 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 LIVING COMMUNITY OF ST JOSEPH 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 412011661 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 ELLENDALE EVERGREEN PLACE 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411796445 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 CITY OF LAKES CARE CENTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411985663 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 CATHOLIC RESIDENTIAL SERVICES 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 390982340 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BLC-BISMARCK 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 264376543 SENIOR LIVING COMMUNITY MN 501(C)(3) LINE 10 BHS 1 BLC- OWATONNA 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411852273 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BLC OF WINSTED 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 274219293 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BLC OF WAHPETON 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 454274091 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 BLC OF ST PETER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 861113231 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BLC OF NEW LONDON 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 274218436 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BENEDICTINE SENIOR LIVING COMMUNITY OF STPETER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 272716531 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BENEDICTINE LIVING COMMUNITIES INC 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411639687 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BENEDICTINE CARE CENTERS 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411907571 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 BRIDGES CARE CENTER 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 262620983 ASSISTED LIVING MN 501(C)(3) LINE 10 BHS 1 VILLA ST VINCENT 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411352227 NURSING HOMES MN 501(C)(3) LINE 10 BHS 1 VILLA ST BENEDICT 1920 MAPLE AVENUE LISLE IL 60532 364343235 NURSING HOMES MN 501(C)(3) LINE 10 N/A 0 CERENITY CARE CENTER - WHITE BEAR LAKE 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411983267 NURSING HOMES MN 501(C)(3) LINE 10 N/A 0 CERENITY SENIOR CARE 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411983267 NURSING HOMES MN 501(C)(3) LINE 10 N/A 0 NAZARETH LIVING CENTER 2 NAZARETH LANE STLOUIS MO 63129 431450394 NURSING FACILITY MN 501(C)(3) LINE 10 N/A 0 BENEDICTINE HEALTH SYSTEM 6499 UNIVERSITY AVENUE NE SUITE 300 MINNEAPOLIS MN 55432 411531892 SUPPORTING ORGANIZATION MN 501(C)(3) LINE 10 N/A 0 BENEDICTINE GROUP SELF-INSURANCE ASSOCIATION 6499 UNIVERSITY AVE NE SUITE 300 MINNEAPOLIS MN 55432 411548753 WORKERS' COMPENSATION PROGRAM MN N/A 0 0 0 1 0 0 0 0 0 0 0 0 0 0 1 0 1 1 0 0 0